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Abstract #9878 Published in IGR 5-3
Glaucoma and ocular hypertension: the importance of intraocular pressure in treatment decisions in France
Bron A; Nordmann JP; Baudouin C; Rouland JF; Kadi A; Sartral MJournal Français d'Ophtalmologie 2003; 26: 895-903
PURPOSE: Several recent clinical studies have shown the benefit of lowering intraocular pressure (IOP) in both ocular hypertensive and glaucoma patients. However, in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT), no consensus on the value of IOP has been reached to prevent the progression of visual field defects. This IOP value, called target IOP, is defined by the ophthalmologist according to the patient and the progression of the disease, with no clear explicit justification of this decision. In France, ophthalmologists' education is mainly based on scientific meetings and the European Guidelines. This study was conducted to investigate the position of the IOP target in the treatment strategy of patients with glaucoma or OHT. MATERIAL AND METHODS: A cross-sectional descriptive survey was conducted in France among ophthalmologists in private practice. Patients with simple OHT or with OAG who required initiation or modification of treatment were included. RESULTS: The authors included 1735 patients (805 males, 46.4%) in the study. OAG was diagnosed in 1338 patients (77.1%) and simple OHT in 397 (22.9%). Patients with OAG were older than those with OHT (65 years versus 61.7 years; p < 0.0001). Most patients (73.5%) were included for treatment modification (77.5% of the patients with OAG and 59.9% with simple OHT; p < 0.0001). The main reason for treatment change was unsatisfactory IOP value. The main therapeutic objective was to reach a target IOP in 46.0% of the patients. The choice of ocular hypotensive drugs depended on the IOP value in 51.9% of the patients. When the treatment was modified, monotherapy was preferred in 60.8% of patients. CONCLUSIONS: Among ophthalmologists, the main objective of the treatment of patients with simple OHT or OAG was to reach a target IOP. About half the participants were used to set up a target pressure for their patients. This fairly good ratio shows the comprehensiveness and the adaptation of our colleagues to relatively new concepts in treating and managing patients with ocular hypertension or chronic open-angle glaucoma. If a modification in the treatment was necessary, then monotherapy was preferred. This decision was motivated by the efficacy of the treatment, but also by expected better patient compliance. LA: French
Dr. A. Bron, Service d'Ophtalmologie, CHU Hôpital Général, 21000 Dijon, France. Alain.bron@chu-dijon.fr
Classification:
11.1 General management, indication (Part of: 11 Medical treatment)
